ozone therapy,dentistry,paedodontics

1. OZONE THERAPY
UNDER GUIDED BY:
PRESENTED BY :
DR.MONIKA PANDEY
M.D.S. 1ST YEAR
A REVOLUTIONARY NON INVASIVE
THERAPY IN DENTISTRY

2. CONTENT:
1. Introduction
2. History
3. Mechanism of action
4. Dental ozone generators
5. Ozone administration
6. Indication
7. Clinical application of ozone
8. Ozone toxicity
9. Cure for ozone toxicity
10.Contraindication
11.Conclusion

3. INTRODUCTION:
• For over 130yrs, millions of people have benefited from the
effects of ozone to eliminate disease and encourage natural
healing.
• It is a blue gas, with strong odour and most important
gas in the stratosphere due to its ability to filter UV rays
which is critical for maintenance of biological balance in
the biosphere.

4. • In nature, ozone is formed by combination of
oxygen in the air under the influence of factors such
as UV radiation (from the sun), electrical
discharges(lightening) and intense physical stress
on water (such as water falls & ocean waves
crashing onto rocks).
• ozone in stratosphere has a critical role in both the
thermal structure of the stratosphere as well as the
ecological framework for life on the Earth’s surface

5. • Occupational exposure to ozone occurs through its
production by office photocopying equipment, electric arc
welding, mercury vapour lamps, laser printers, X-ray
generators and high voltage electrical equipment etc.
• Ozone therapy was used extensively to treat infections,
battle wounds and in routine treatment of cancer up to
1950’s. But later the advent of chlorine water sterilization
which is more economical declined the use of ozone .

6. • However research is showing that this ‘old’ technology has
a very important role to play in medical and dental
treatment especially with the development of multiple
resistant microorganisms to antimicrobials.
• Medical grade ozone is made from pure medical oxygen
because oxygen concentration in the atmospheric air is
variable
• O3 is a powerful oxidant capable of interacting as
metabolic & immune modulator as well as anti-microbial
agent. Multiple microbiological & the biochemical studies
justified that there are no doubts about the effectiveness
of ozone in bacterial reduction

7. There are three different systems for generating
ozone gas.
1. Ultra violet system: produces low concentrations of
ozone, used in aesthetics & for air purification.
2. Cold plasma system: used in air and water purification.
3. Corona discharge system: produces high concentrations
of ozone. It is the most common system used in the
medical/dental field.

8. HISTORY:
• Christian Friedrich Schönbein (1840), a German Chemist,
is regarded as the Father of ozone therapy. When he
passed an electrical discharge through water, a strange
smell was produced, which he called Ozone, derived from
the Greek word ‘OZEIN’ which means odor.
• In 1857 Joachim Hänsler, a German physicist and
physician, along with German physician,developed the first
ozone generator for medical use.
• In 1860,Monaco first used it in water treatment plants .

9. • Dr. C. Lender in 1870. He purified blood in test tubes by
using O3 . Later, O3 application gained as a popularity as a
therapeutic procedure throughout Europe and America
• In 1881, it was used as a disinfectant in the treatment of
diphtheria.
• In October 1893, Ousbaden, Holland became the first city
to utilize a water treatment plant using ozone.
• In World War I and II it was used to treat wounded
soldiers in the trenches .

10. • In early 20th century Food and Drug Act, revised its use
and effect in the field of medicine.
• A German dentist, Dr. E.A. Fisch, in 1950, used ozonated
water for dental procedures and pioneered its use in
medicine.

11. MECHANISM OF ACTION:
• There are several actions of ozone such as anti-microbial,
anti-inflammatory, analgesic, immune stimulating, anti -
hypoxic, detoxicating, bio-energetic and biosynthetic
(activation of the metabolism of carbohydrates, proteins &
lipids) actions.

12. Anti–microbial action:
The antibacterial effect of ozone occurs as a result of its
oxidant action on cells by damaging its cytoplasmic
membrane due to ozonolysis of dual bonds. It does not
damage healthy human body cells because they have
superoxide ,catalase, hydrolase and antioxidant nutrients
like vitamin C &E which inhibit the uncontrolled activity
of free radicals and thus all healthy cells are protected.
Only unhealthy cells such as cancer cells which have lost
this protective mechanism and organisms such as
bacteria, viruses, fungi, parasites which are devoid of
these antioxidants are destroyed.

13. Anti –inflammatory & analgesic action:
Ozone helps in the synthesis of biologically active
substances such as prostaglandins which is beneficial in
reducing inflammation and pain.
Immune-stimulating action:
The electromagnetic action of ozone stimulates and
modulates immune system particularly lymphocytes.the
application of medical ozone is extremely useful for
immune activation of patients especially with a low
immune status.

14. Anti-hypoxic action:
Ozone brings about the rise of O2 in tissues and improves
transportation of oxygen in blood Ozone acts as a super-
oxygenator, bringing oxygen to tissues, assisting body in its
natural healing process.
Bioenergetic and biosynthetic action:
Ozone activates mechanisms of protein synthesis,
increases amount of ribosomes and mitochondria in cells,
elevating functional activity and regeneration potential of
tissues and organs.

15. DENTAL OZONE GENERATORS;
HEAL OZONE:
• The ozone unit for dental use was initially developed
by CurOzone Inc. (Canada) and subsequently
manufactured under license and distributed by KaVo
Dental GmbH and Co. (Germany) under the name
“HealOzone”.

16. HEALOZONE PROCEDURE:
The HealOzone procedure consists of a package which
includes:
• The application of ozone gas, the use of remineralizing
agents, a patient kit and information on oral hygiene.
• The HealOzone device comprises an air filter, vacuum
pump, an ozone generator, a hand piece fitted with a
sealing silicone cup and a flexible hose.
• The procedure usually takes between 20 and 120 second
per tooth.

17. • Immediately after ozone application the tooth
surface is treated with a remineralizing solution
(reductant) containing fluoride, calcium, zinc,
phosphate.
• HealOzone application for the treatment of non
cavitated lesions is usually repeated at 3 and 6
months.

18. The OzoTop :
• The OzoTop is a free flow ozone delivery system using a
corona discharge. It is a compact, easy to use tabletop unit.
Due to the delivery system of the OzoTop, root canals and
periodontal pockets can be penetrated easily. The system
may be used in all cases where point of placement
disinfection is needed, including periodontology,
endodontology, restorative, implantology, apthous
ulcers/herpes,dentures and impression materials.
• Ozone is applied at 6, 12, 18, 24 seconds, depending on
which treatment is required.

19. OZONE ADMINISTRATION:
There are three basic forms of ozone application.
1. ozone gas
2. ozonated water and
3. ozonated oil
• These forms of application are used singly or in
combination to treat dental disease.
• Ozone gas has a half life of about 5-30 min
• Ozonated water has a life span of about 10hrs if the water
is kept cold.
• Ozonated oil produces a stable product (ozonides) with a
longevity exceeding 15 yrs.

20. INDICATIONS:
I. Arterial circulatory disorders
II. Immunodeficiency and Immune
disbalance - Additive therapy in carcinoma patients
diseases caused by viruses (e.g.,: Hepatitis)
III. Inflammatory conditions
IV. Rheumatic diseases
V. External ulcers and skin lesion
VI. External ulcers and skin lesions
VII. Dentistry.
Ozone is also used in the pharmaceutical industry, food
processing industry, fabrics and cosmetics.

21. CLINICAL APPLICATION OF OZONE IN
PEDIATRIC DENTISTRY:
With all the evidence of different actions and lack of toxicity
ozone is developed into a new noninvasive tool for the
treatment of diseases in medicine and dentistry.
• INFECTONS LESION:
Soft tissue lesions like Herpes, Aphthae, Removable
denture ulcers, Cuts, Cheilitis, Candidiasis, Cysts and
Traumatic wounds can be treated with either Ozonated
water or oils. The disinfectant and healing properties help
in the healing of these lesions.

22. Remineralization of Incipient Caries:
In superficial root caries or early pit and fissure carious
lesions, ozone alone may be sufficient to treat these
lesions. However, in situations where severe breakdown of
tooth structure has occurred, ozone may be used initially to
promote remineralization and when this has occurred the
cavity may be restored with a suitable restorative material.

23. Restoration of Large Cavitations Along With
Conventional Conservative Measures:
• The larger lesions need special care. It must be stressed that
larger lesions are not those to be treated with ozone alone;
most will require a combined approach of traditional therapy,
as well as ozone. Where the lesion extends deep into the
dentine, the action of ozone will take a longer time period of
treatment, or may require several treatment periods over time.
• The basic protocol is the same; the soft debris is removed along
with any unsupported enamel. If possible, denatured dentine is
removed to the leathery layer. Ozone is applied from 40
seconds or longer. Some practitioners are using 2 to 3 minutes
for large deep lesions that extend on x-ray almost to the pulp
chamber. Then, the remineralizing wash is applied.

24. Bleaching :
• In root canal treated teeth , crown discoloration is a major
aesthetic problem, especially in anterior teeth.
Conventional walking bleach requires much more time and
results are not often satisfactory. Also, capping the tooth
with ceramic crown in young permanent incisors is not
indicated. An alternative option is placing the bleaching
agent then the crown is irradiated with ozone for
minimum of 3-4 minutes. This ozone treatment bleaches
the tooth within minutes and gives the patient a happy and
healthier-looking smile

25. Endodontic Treatment :
• The aim of conventional root canal therapy is to provide a
clean, shaped, root canal that facilitates the placement of an
adequate root filling.
• There may be multiple canals in a single root in this situation,
current procedures can be modified, to greatly improve the
quality of treatment for patients.
• When irrigating with the usual irrigant solution, for example
sodium hypochlorite, ozone can be applied to the hypochlorite
solution in the root canals. This technique allows the root canal
system to be thoroughly disinfected and possibly be sterilized.
• Also that ozone will penetrate through the apical foramen, and
enter into the surrounding and supportive bone tissue. The
effect of ozone on these tissues will be to encourage healing
and regeneration.

26. Ozonated water in decontamination of avulsed
teeth before replantation:
• A high level of biocompatibility of aqueous ozone on
periodontal cells has been found .Two-minute irrigation of
the avulsed teeth with no isotonic ozonated water not only
provides mechanical cleansing, but also decontaminate the
root surface, with no negative effect on periodontal cells
remaining on the tooth surface before replantation

27. Extraction:
• Ozone was found to accelerate the healing of the wounds.
After a tooth is extracted or any surgical procedure the
area is irrigated and insufflated which promotes faster
healing without complications

28. Disinfectant:
• Ozonated water effective for killing gram-positive and
gram-negative oral microorganisms and oral Candida
albicans.
• Gaseous ozone can be clinically useful for disinfection
of dentures

29. OZONE TOXICITY:
• Ozone inhalation can be toxic to the pulmonary system and
other organs. Complications caused by ozone therapy are
infrequent at 0.0007 per application. Known side effects
are upper respiratory irritation, rhinitis, cough, headache,
occasional nausea, vomiting, shortness of breath, blood
vessel swelling, poor circulation, heart problems.
• European cooperation of medical ozone societies
prohibited the intravenous injections of ozone gas due to
risk of air embolism.

30. CURE FOR OZONE TOXICITY:
• The patient must be placed in the supine position.
• The patient should inhale the humid oxygen and treated
with Vitamin E, & ascorbic acid

31. CONTRAINDICATION:
• Pregnancy
• Glucose-6-phosphate-dehydrogenase deficiency
• Hyperthyroidism
• Severe anemia
• Severe myasthenia
• Acute alcohol intoxication
• Recent myocardial infarction
• Hemorrhage from any organ
• Ozone allergy.

32. CONCLUSION:
• Ozone therapy allows a new vision, which complies with
needs and demands of the public for noninvasive, effective
dental care and it is truly a paradigm shift in dental
practice.
• Ozone therapy has opened new ways in treatment for
dental patients of all ages and applicable to a wide range of
conditions of intra oral hard and soft tissues.
• It is especially suitable to the younger patients who are
often scared of “drilling” and find conventional treatment
unacceptable.

33. • The ozone therapy has been more beneficial than present
conventional therapeutic modalities that follow a minimally
invasive and conservative application to dental treatment.
• Treating patients with ozone therapy reduces the
treatment time with a great deal of difference, and it
eliminates the bacterial count more precisely.
• The treatment is completely painless and increases the
patients’ acceptability and compliance with minimal
adverse effect